Robey S S, Silva E G, Gershenson D M, McLemore D, el-Naggar A, Ordonez N G
Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Cancer. 1989 Mar 1;63(5):839-47. doi: 10.1002/1097-0142(19890301)63:5<839::aid-cncr2820630508>3.0.co;2-u.
We reviewed 53 high-grade carcinomas of the ovary in order to define pathologic features that correlate with prognosis. All tumors were Stage III with comparable amounts of residual tumor left after the primary resection. Similar postoperative chemotherapeutic regimens were given to each patient, and there was a clinical followup of at least four years in each case. The tumors were classified according to their predominant (greater than 50%) histology as transitional cell carcinoma (TCC) (18 tumors), papillary serous (18), undifferentiated (8), or endometrioid (3). There were six mixed carcinomas without predominant histology. In 17 of 18 patients, TCC predominant tumors responded completely to chemotherapy and 15 of 18 patients (83%) are alive without disease 4 to 10 years after presentation (average 6.8 years). In comparison, tumor progression/recurrence developed in 31 of 35 non-TCC tumors (18 serous, eight undifferentiated, one endometrioid predominant, and four mixed carcinomas). Of these 35 patients, 27 (77%) died of disease from 6 months to 7 years after presentation (average 2.5 yrs.). Flow cytometric determination of DNA content and immunoperoxidase studies did not allow discrimination between the histologic types of high-grade ovarian carcinomas. We conclude that TCC should be recognized as a distinct histologic type of ovarian carcinoma because of the favorable response to chemotherapy and improved patient survival.
我们回顾了53例高级别卵巢癌，以确定与预后相关的病理特征。所有肿瘤均为Ⅲ期，初次切除后残留肿瘤量相当。每位患者均接受了相似的术后化疗方案，且每例患者均有至少4年的临床随访。根据其主要（超过50%）组织学类型，将肿瘤分类为移行细胞癌（TCC）（18例肿瘤）、乳头状浆液性癌（18例）、未分化癌（8例）或子宫内膜样癌（3例）。有6例混合性癌，无主要组织学类型。在18例患者中的17例中，以TCC为主的肿瘤对化疗完全缓解，18例患者中的15例（83%）在就诊后4至10年无病存活（平均6.8年）。相比之下，35例非TCC肿瘤（18例浆液性癌、8例未分化癌、1例以子宫内膜样癌为主和4例混合性癌）中有31例发生肿瘤进展/复发。在这35例患者中，27例（77%）在就诊后6个月至7年死于疾病（平均2.5年）。流式细胞术检测DNA含量和免疫过氧化物酶研究无法区分高级别卵巢癌的组织学类型。我们得出结论，由于对化疗反应良好且患者生存率提高，TCC应被视为卵巢癌的一种独特组织学类型。
